Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $194.98	Facility		$190.55	$190.55	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $371.54	Professional		$190.55	$190.55	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $245.47	Professional		$194.98	$194.98	$245.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $204.17 / $316.23	Professional		$87.10	$204.17	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $169.82 / $407.38	Facility		$151.36	$169.82	$407.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $181.97 / $218.78	Professional		$162.18	$181.97	$218.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $426.58	Facility		$181.97	$181.97	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $190.55 / $204.17	Professional		$169.82	$190.55	$204.17
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55